Medical Surgical ALS #3

Question

The newly diagnosed ALS client’s family member asks the nurse why the client is constipated. What is the best reply from the nurse?:

Answers

  1. “The client is probably not eating enough fiber. I will contact
    • Rationale:

      This answer is not correct because it insinuates that the fault is with the client. However, increasing fiber intake is an appropriate intervention for the ALS client with constipation.

  2. Dietary to add more vegetables to bulk up his stools.”
    • Rationale:

      This answer is not correct because ALS does not harden the stool. It causes muscle weakness which leads to decreased mobility.

  3. “ALS affects the bowels by hardening the stool and making it more difficult to pass.”
    • Rationale:

      This answer is not correct because in ALS, the nerves do not miscommunicate, they deteriorate and die. This happens when the disease has progressed and damages the nerves that are responsible for waste transit, preventing the intestines to remove the stool effectively.

  4. “The disease causes the nerve cells to miscommunicate during waste transit and draw water out of the stool, making it more difficult to move.
    • Rationale:

      This answer is correct because immobility decreases the movement of the stool through the intestines. Increasing fluid and fiber intake will aid the passage of stool more efficiently for the ALS client. As the disease progresses, it may be necessary to add a laxative due to the weakness of the bowel muscles from disease.

  5. “The disease's effect on the muscles which causes lack of mobility leads to decreased peristalsis, which contributes to the client's constipation.â€
    • Rationale:

Overview

Amyotrophic lateral sclerosis (ALS) is an accelerating neurogenic disease that negatively affects the nerve cells that control voluntary muscles. This leads to muscle atrophy and weakness which eventually causes immobility.

Explanation

Learning Outcomes

Amyotrophic lateral sclerosis (ALS) is also known as Lou Geherig’s disease. It is an accelerating neurogenic disease that negatively affects the nerve cells that control voluntary muscles. It causes weakness in many muscles of the body causing the client to become less mobile to eventually, immobile. In the early stages of the disease, the lack of mobility contributes to constipation because of decreased peristalsis. Eventually, as the disease progresses, the nerves that send messages to the muscles that removes waste from the intestines deteriorate and die. In the early stages, if it is possible, exercise can help improve regularity. But as the disease progresses, use of laxatives may be necessary.

Test Taking Tip

Notice the client is “newly diagnosed” with ALS.

Video Rationale